Summary of findings 4. Radiotherapy alone compared with full axillary surgery for operable primary breast cancer.

Radiotherapy alone compared with full axillary surgery for operable primary breast cancer
Patient or population: women with operable primary breast cancer Settings: hospital Intervention: radiotherapy alone Comparison: full axillary surgery
Outcomes	Illustrative comparative risks* (95% CI)		Relative effect (95% CI)	Number of participants (studies)	Quality of the evidence (GRADE)
	Assumed risk	Corresponding risk
	Full axillary surgery	Radiotherapy alone
All‐cause mortality	81% overall survival at 5 yearsa	79% overall survival at 5 years (77% to 81%)	HR 1.1 (1 to 1.21)	2469 (4 studies)	⊕⊕⊕⊕ high
Local recurrence	90% local recurrence‐free survival at 5 yearsb	92% local recurrence‐free survival at 5 yearsa (90% to 93%)	HR 0.8 (0.64 to 0.99)	22,256c (4 studies)	⊕⊕⊕⊕ high
*The basis for the assumed risk (e.g. median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; HR: hazard ratio.
GRADE Working Group grades of evidence. High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.

^aAssumed risk from full axillary surgery arm of NSABP B‐04 using mean 5‐year overall survival in combined N+ and N‐ groups.
 ^bAssumed risk from full axillary surgery arm of NSABP B‐04, using mean 5‐year risk for local or regional recurrence in combined lymph node‐positive and ‐negative groups.
 ^cPerson‐years of follow‐up.